I have to say that most conservative arguments seem unconvincing and weak to me on health care. The arguments about "We don't want government making decisions for us!" is easily countered by "A bureaucrat in an insurance company is better?" The argument saying "The government breaks everything it touches!" falls down when you consider the high efficiency of Social Security and Medicare (I know they are not sustainable, but neither is a health care industry that increased in cost 87% in the last 10 years. Social Security and Medicare are more sustainable than that.) Arguments about choosing doctors fall flat when Canada's single payer system allows you to choose any doctor, anywhere, and they have a much higher percentage of private practice doctors than Americans. Arguments about how happy people are with their health insurance fall flat when you realize most of those happy with their insurance have never dealt with a financially crippling illness, which almost always leads to bankruptcy.
So what's a conservative to do?
There are some much better arguments that I don't see prominent conservatives making.
Single payer systems are completely unrealistic when you consider they would instantly eliminate $100 billion+ in market capitalization due to the health care insurance companies no longer able to sell a product. Are we cool with eliminating $100 billion from our economy right now? Along with all the jobs? Didn't we just bail out a company worth $55 billion in 2000? (GM, I'm looking at you.) It's crazy talk to consider this as an option. And even if you do replace a 15% insurance company cost with a 4% government administration cost, you are only saving 11% of the cost by choosing single payer.
Any solution that attempts to alleviate the pain of health care's costs needs to focus on.... Health care costs! Right now, the insurance companies have had no incentive whatsoever to rein in costs. They always get their 15% no matter what the care actually costs. Consumers have no real clue what the procedures cost, so what would they have to complain about?
I had a routine physical a few weeks ago, and was shocked to see that my insurer paid $500 for the work. In that time, I spent 5 minutes with a doctor, and 7 minutes with a nurse! And that was it! $500? I could get a very high priced lawyer for the same cost and he would spend the entire 60 minutes chatting with me about anything I wanted to chat about.
We have seen that the current system has no mechanism for making providers justify their costs, and I believe that is the true problem. If a provider had to explain why it cost them $500 to spend 12 minutes with me, and it was easy for me to compare what providers cost, and what their patient outcomes were, I would generally choose the best care for the lowest cost. Transparency helps solve lots of problems, and transparency can definitely work here. Today, the workings of health care are far too arcane and esoteric. When we see a provider gouging people on the provider costs & outcomes website, let the market punish them! Imagine the fun of browsing this site. "Hey honey, look at this doctor! Half of his patients die!"
I believe that there is value to making sure that everyone has access to care. I believe most Americans believe that as well. I believe in mandated health insurance just as I believe in mandated car insurance. And I believe that when people cannot afford to pay for health care, we all suffer. The government seems to be good at loaning people money these days, so let the government loan health care money to those who can't afford it. Many will never repay the loan, but some will. Some will gladly repay it as their fortunes increase.
And finally, make this problem a states problem. It costs far more to operate a practice in Manhattan than it does in Seattle, Washington, or Butte, Montana for that matter. The federal government can mandate that the states must come up with a solution that makes sense for them. The federal government can mandate insurance purchase. The federal government can mandate that the providers provide complete transparency as to costs and outcomes. The federal government can loan the poor money to pay their premiums.
Some states can choose to become a single payer system, allowing more doctors to practice more profitably because they don't have to hire huge administrative staffs to manage claims. Some states can choose to continue to manage multiple insurance providers. Some states can keep things as they are. And we, the people, will vote with our feet. As always.